Last reviewed dd mmm yyyy. Last edited dd mmm yyyy
The HAS-BLED is a therapeutic bleeding risk stratification score for those on oral anticoagulants in atrial fibrillation (1).
HAS-BLED score for bleeding risk on oral anticoagulation in atrial fibrillation
Feature | Score if present |
Hypertension (Systolic >= 160mmHg) | 1 |
Abnormal renal function | 1 |
Abnormal liver function | 1 |
Age >= 65 years | 1 |
Stroke in past | 1 |
Bleeding | 1 |
Labile INRs | 1 |
Taking other drugs as well | 1 |
Alcohol intake at same time | 1 |
HAS-BLED score may underestimate bleeding risk in a subset of atrial fibrillation patients (2)
NICE have suggested that the ORBIT bleeding risk score should be used (in comparison to other bleeding risk scoring systems such as HAS-BLED) in assessing the risk of bleeding when a patient commences, or is under review, regarding anticoagulation therapy in atrial fibrillation (3).
NICE state that "because evidence shows that it has a higher accuracy in predicting absolute bleeding risk than other bleeding risk tools. Accurate knowledge of bleeding risk supports shared decision making and has practical benefits, for example, increasing patient confidence and willingness to accept treatment when risk is low and prompting discussion of risk reduction when risk is high. Although ORBIT is the best tool for this purpose, other bleeding risk tools may need to be used until it is embedded in clinical pathways and electronic systems..."
Click here for online ORBIT risk calculator
Reference:
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